Spondylolisthesis: Etiology, Diagnosis, Clinical Features and Treatment

Abstract

Spondilolistezis, 18. yüzyıldan bu yana bilinen bir patolojidir. Basit mekanik bel ağrısından, ilerleyici nörolojik defisit ve radyolojik bulgulara kadar değişen geniş bir klinik spektrum olarak karşımıza çıkar (1). Kayma olmaksızın nöral arkın pars interartikularisinin veya isthmusun tek veya çift taraflı defektine spondilolizis denir (2). Defekt bilateral olduğunda; nöral arkın anterior ve posterior elemanları ayrılır. Bu durum spinal kolonda instabiliteye yol açar ve üstteki vertebral segmentin bir sonraki kaudal segmente göre anatomik konumunun bozularak öne, arkaya ve yanlara doğru kaymasına spondilolistezis denir (2,3). Fakat bu terimle daha çok öne doğru kayma olan anterolistezis kastedilir. Vertebranın anatomik konumunun bozularak arkaya doğru kaymasına ise retrolistezis denir (2). Spondylolisthesis is anterior or posterior shift according to the vertebrae to which a vertebrate is associated. It is confronted as a broad clinical spectrum ranging from simple mechanical back pain to progressive neurological deficits and radiological findings. Prevalence is 3-6% and male/ female ratio is 2. The diagnosis of spondylolisthesis is almost always made with direct radiographs. Computed tomography (CT), magnetic resonance imaging (MRI), other radiological diagnostic methods such as bone scintigraphy are also used in diagnosis or follow-up. Conservative treatment includes activity restriction, rehabilitation of abdominal and paraspinal muscles and hyperlordotic rigid bracing. The main goal is to reduce pain, strengthen the core of the muscles and to provide complete lumber motion. Surgical treatment is usually performed in patients who do not respond to conservative treatment. We aimed to review current literature regarding the etiology, diagnosis, clinical features and treatment of spondylolisthesis.